General Health

Sleeping Positions

Positions you should avoid:

1. Lying on your stomach– This position makes you maintain a position of head rotation. This causes your neck muscles to shorten and can result in pain and stiffness in the morning. Also, sleeping flat on your stomach extends your low back which causes shortening and tightening of the low back muscles.

2. Lying on your side with your arm above your head– This position can create shoulder pain. You can compress the nerves in your shoulder causing your arm to go numb. Also, you are impinging the shoulder joint. This can cause stiffness and soreness at the shoulder joint.

Ideal sleeping positions:

1. Lying on your side with your arms in front of your body and a pillow between your knees– This causes decrease strain on your shoulder and allows your back muscles to remain relaxed. The amount of pillows under your head should be determined by your neck position. Your neck position should be in a slightly flexed position compared to the rest of your body.

2. Lying on your back– In this position, you should make sure you are using the correct amount of pillows as noted above. Also, place pillows under your knees to create a position of decrease strain on your lower back.

Please note if you have current or previous injuries, the position you favor will depend upon making the area of injury as comfortable as possible. If you continue to have difficulty getting comfortable in bed, make an appointment to your local physical therapist. The therapist will determine which position will better suit you based upon your past and current medical history.

Morton’s Neuroma

A Morton’s neuroma is a thickening of the tissue around one of the nerves leading to your toes. Most commonly it occurs between your 3rd and 4th toes. It is also most common in middle aged women and early intervention is important.

Symptoms of a Morton’s neuroma include, tingling, numbness, burning, or pain at the ball of the foot. A common report is symptoms mimicking something stuck to the bottom of your foot.

One of the most common causes is improper footwear. Wearing shoes without much support like flip flops, high heels, and flats can cause a compression and irritation of the nerve. Other causes are previous foot problems and repetitive damage from sports.

Early treatment should include ice and changing footwear. If symptoms persist, consult with your local physical therapist. Physical Therapy would include massage to the foot, stretching, and exercises. This works to help to decrease inflammation and increase blood flow to promote healing. A physical therapist can also educate you on proper foot wear and orthotics. Injections may be needed to help decrease the inflammation. If conservative measures are not successful, surgery is performed to release pressure on the nerve.

X-ray vs. MRI

An x-ray determines the alignment and condition of your bones. Examples of things x-rays can display are deformities of the spine, fractures, bone spurs, tumors, spaces between the discs of the spine, and infections.

MRI stands for magnetic resonance imaging. MRI’s will determine the condition of your muscles/ligaments and the discs in your spine.  Your doctor may not order an MRI initially. Typically no matter what is displayed on the MRI, a physician would recommend physical therapy as the first form of conservative treatment.  An MRI will help the doctor determine if surgery is required for your injury.

Food Safety in the Summer

Food can spoil easily on hot summer days; follow these tips to prevent spoiling your fun with food borne illness. 

  • Plan picnics to include foods that don’t require refrigeration: fruit salad vs. pasta salad (mayo can spoil), PB and J vs. meat sandwiches
  • If the temperature outside is above 90 degrees, food cannot stay out for longer than 1 hour

 Practice Safe Food Handling Techniques:

  • Wash hands, utensils, and food preparation surfaces – moist towelettes are a quick and easy choice for your hands when playing outdoors
  • Rinse fresh fruits and vegetables with water before packing
  • Serve safely keeping cold foods cold (<40 degrees) and hot foods hot (>140 degrees)
  • Don’t cross-contaminate: wash all surfaces very well that have touched raw meats and juices.  Keep raw meats wrapped so that juices don’t touch other foods
  • When preparing salads, chill ingredients before combining (even canned tuna should be chilled before mixing in the mayo!)

Transport Foods Safely:

  • Transport perishables as quickly as possible, and cook immediately or refrigerate
  • Keep perishables refrigerated until just before leaving
  • Consider packing beverages in a separate cooler from perishables
  • Meat, poultry, and seafood may be packed frozen so it stays colder longer
  • Plan food portions to avoid leftovers; place condiments in small containers
  • Place cold foods in an insulated cooler with ice packs and don’t pack up until you’re almost ready to leave. You can also nest perishables in bowls of ice to stay chilled
  • Carry your cooler in an air-conditioned car and place in the shade; keep the lid closed as much as possible
  • Discard leftovers if they have been out of the cooler for longer than 1 hour; if you have to question it – throw it out!

Written by Julie Katz Registered Dietitian- Baltimore, MD

What is good posture and which exercises can I do at the gym to improve my posture?

While standing, if you can draw an imaginary straight line through your earlobe, the tip of your shoulder, through your knee, and the middle of your ankle, you have good posture. Standing with good posture usually involves doing a slight chin tuck so your head is over your shoulders, pulling your shoulders back and tucking in your stomach.

Good posture lends to less stress on your joints and muscles resulting in less discomfort and risk for injury.  At first, maintaining good posture may be tiring. Eventually, you will build up the endurance in your muscles and it will come more naturally.

Here are some examples of stretches that you can perform to help achieve good posture. 

Pectoralis muscle stretch– Just put your hands up on a doorway and gently step through with one foot until you feel a stretch. All stretches should be held between 15-60 seconds.

Corner Stretch

Hamstring stretch– You can sit or stand. Put one foot up on a step or the coffee table and lean toward your foot.

Hamstring stretch

Shoulder blade squeezes– You can just squeeze your shoulder blades together or use an exercise band to row your shoulder blades together.

Rest position

Scapular Retraction

Good posture involves training the body to be in a position that results in less strain on your muscles and joints. If you are looking to improve your posture or decrease your neck/back pain with long-term sitting or standing, make an appointment at Harbor Physical Therapy for an individualized treatment program.

The Benefits of Balance Training

Balance exercises help to rehabilitate, restore, and prevent ankle and knee injuries. They work to increase the stability of the joints in the lower extremity. Balance training can also help to prevent falls in the elderly population. Balance training improves proprioception, which is the ability to know where your joints are in relation to one another.

An example of a basic balance exercise is standing on one leg and trying to maintain the position for a certain period of time.  To progress this exercise, it can be performed on an unsteady surface to increase the amount of strength/stability required for the exercise.   If you have a chronic ankle or knee injury, you would benefit from physical therapy using balance training to improve the strength/stability of your joints.

single leg stancesingle leg stance on an uneven surface

Tips to Reduce Back Pain While Driving

Most car manufacturers develop their seating options based on the aesthetics of the car versus the comfort of the driver and passenger.  Back pain can develop or increase from improper seating posture while driving.  Finding the correct seating setting is beneficial, especially for people that drive as an occupation. Therefore, listed below are some tips to reduce back pain while driving.

  1. Avoid driving for more than 2 hours at a time. Get out of the car, walk, and stretch your legs.
  2. Sit with your bottom all way back in the seat and use the vehicles built in lumbar support to provide cushion to your lumbar spine. If you don’t have a lumbar support, roll up a towel and place it in the curve of your low back.
  3. The back rest should have about a 10-15 degree incline. Most people tend to have the back rest too far tilted backward.
  4. Your knees should have about a 45 degree bend. You don’t want your legs so straight that you are reaching for the pedals. It you are short, some dealerships sell pedal extensions.
  5. Use cruise control while on long highway driving.
  6. Try to maintain good posture, and make sure you have good visibility with your mirrors.
  7. Take the wallet out of your back pocket and avoid wearing a tight belt. This can add pressure to the back.
  8. For long car trips, adjust your seat every 30 minutes. To prevent constant pressure on the same areas on your body, slightly adjust the backrest angle.

Healthy Holiday Eating Tips- Part 2

Menu Planning Tips: Modify your traditional holiday menus and recipes to reduce fat, cholesterol, and calories.

•
Original Menu
3 ½ ounces roast duck
½ cup stuffing
½ cup broccoli with hollandaise
sauce
½ cup jellied cranberry sauce
1 medium crescent roll
1 slice pecan pie
TOTAL CALORIES = 1205
TOTAL FAT = 55 grams
•
Leaner Menu
3 ½ ounces roast turkey breast
½ cup rice pilaf
½ cup broccoli with lemon juice
½ cup fresh cranberry relish
1 fresh roll
1 slice pumpkin pie
TOTAL CALORIES = 730
TOTAL FAT = 21 gra

A typical holiday menu:

  • 3 ½ ounces roast duck
  • ½ cup stuffing
  • ½ cup broccoli with hollandaise sauce
  • ½ cup jellied cranberry sauce
  • 1 medium crescent roll
  • 1 slice pecan pie
  • TOTAL CALORIES = 1205
  • TOTAL FAT = 55 grams

A leaner holiday menu:

  • 3 ½ ounces roast turkey breast
  • ½ cup rice pilaf
  • ½ cup broccoli with lemon juice
  • ½ cup fresh cranberry relish
  • 1 fresh roll
  • 1 slice pumpkin pie
  • TOTAL CALORIES = 730
  • TOTAL FAT = 21 grams

Remember to go easy on the following foods:

  • Nuts
  • Chips
  • Crackers
  • Dips
  • Olives
  • Eggnog
  • Stuffing
  • Gravy
  • Fatty deli meats
  • Candy, cakes, pies, cookies
  • Alcohol

Celebration Strategies:

  • Be realistic. Trying to lose weight during the holidays may be a self-defeating goal. Striving to maintain your weight, however, is a reasonable expectation.
  • Forget the “all or nothing” mindset. Depriving yourself of special holiday foods or feeling guilty over a particular food choice are not part of a holiday eating strategy – and certainly not part of the holiday spirit!
  • Have fun! Sharing food is an important way to spread holiday cheer. Enjoying a traditional meal or celebrating with family and friends need not destroy the healthy food habits you have nurtured all year.
  • Get enough rest.
  • Drink lots of water.
  • Get at least 30 minutes of brisk exercise every day to reduce stress and burn calories (try it before breakfast).
  • Don’t skip meals, especially breakfast.
  • Eat slowly – put your fork down between bites.
  • Chew gum while preparing food and cleaning up to curb tasting and snacking.
  • Keep a daily food/calorie diary – enter every taste and snack you take.
  • Resist the urge to bake as gifts, instead make jellies, barbecue sauces, etc.

Snacking During the Busy Holiday Season:

With all the preparations and celebrations, you might be too busy to eat regular meals. Take some time to learn how tasty, convenient snacks and appetizers can fill hunger gaps, contribute important nutrients, and add enjoyment to your holiday eating.

  • Try these portable snacks when you travel:
    • Make a trail mix of nuts, raisins, and pretzel chips
    • Tote some of your favorite ready-to-eat cereal in a plastic bag
    • Stow a couple of breadsticks and a crisp apple
    • Pack a handful of graham crackers and small can of fruit juice
    • Wrap up a mini-bagel spread with peanut butter
  • For home, try stocking up on these snacks:
    • Raw broccoli florets
    • Red and green pepper strips
    • Zucchini circles
    • Cucumber wedges
    • Carrot and celery sticks
    • Low-fat, low-sodium cheeses
    • Lean, low-sodium deli meats
    • Fruit
    • Yogurt
    • Juices
    • Assorted bread, crackers, graham crackers, pretzels, and breadsticks
    • Cook a large batch of chili and freeze individual portions, reheat as needed
  • Snack ideas for company
    • Top reduced-fat crackers with your favorite hors d’oeuvre combinations
    • Serve hummus with pita wedges
    • Make fruit kabobs with pineapple chunks, melon balls, and ripe strawberries
    • Arrange colorful vegetables on a platter with a tangy yogurt dip
    • Place bowls of homemade snack mix on convenient tables
    • Create a cheese board with some new lower-fat varieties and an assortment of crackers and breadsticks
  • For a sweet treat:
    • Slices of angel food cake drizzled with raspberry sauce
    • Non-fat and lower-fat cookies
    • Dried fruit and nuts arrangement
    • Serve small portions of special holiday sweets

Written by Julie Katz, Registered Dietitian- Baltimore, MD

Healthy Holiday Eating Tips- Part 1

Food is an integral part of holiday festivities with many of the traditional treats being high in calories and fat. You may be asking yourself, “How can I enjoy the holidays and still manage to maintain a healthful diet?”  The secret is moderation and balance so that you may fit in some of your holiday favorites.

Party Tips: It may be difficult to juggle drinks, plates, and conversation during these stand-up events, but try to still pay attention to the foods you are eating.

  • Eat small, lower-calorie meals during the day so you can enjoy a special treat later. Eat a healthy snack right before the party – a hungry stomach can sabotage even the strongest will-power.  Try a smoothie of skim milk and fruit to take the edge off your appetite.
  • When you arrive at the party, don’t rush to the food. Greet people you know, get a low-cal beverage, and settle in.
  • Make only one trip to the buffet and be selective. Choose only the foods you really want to eat. Keep portions small. Often, a taste is all you will need to satisfy a craving or your curiosity.
  • Skip the fried food and eat the crackers, bread, and fruit. If you want to nibble on cheese, take only one or two pieces.
  • Fresh vegetables are always great. Have a small dollop of dip, just enough to coat the end of the carrot stick, or broccoli floret.
  • Boiled shrimp or scallops are a good choice. Choose cocktail sauce or lemon and horseradish as a condiment.

Dinner Party Tips: With a meal already planned and out of your hands, you may not have a menu choice.

  • If you are bringing a dish, make a lower-fat version of a family favorite.
  • If possible, choose two appetizers instead of an entrée, or share an entrée with a friend.
  • If second helpings are mandatory with your host, make your first helping small. That way, if you’re enticed to take seconds, at least the total amount of food you eat may equal a normal-sized portion.
  • Choose skinless white meat of poultry. It has fewer calories and fat than dark meat.
  • Eating a roll is fine. If it’s fresh, you may not even need butter or margarine.

Written by Julie Katz, Registered Dietitian- Baltimore, MD

Plantar Fasciitis

What is Plantar Fasciitis?

Plantar Fasciitis is an irritation of the thick ligamentous connective tissue on the bottom of the foot. This band of tissue runs from the heel to the ball of the foot providing support for the arch of the foot.  Plantar fasciitis is common in runners.

Causes of Plantar Fasciitis

1. Over pronating with walking/running– pronation is where the inside of the foot touches the ground more than the outside.

2.  Wearing old shoes– shoes lose their support after approximately 500 miles of wear.

3.  Excessive walking with improper foot support– shoes that do not provide arch support.   An orthotic might be needed to provide increase support to the arch of the foot.

4.  Tight calf muscles

Symptoms:

Pain is felt at the bottom of the heel.  Pain is usually worse in the morning and improves throughout the day.  Pain increases with prolonged standing or sitting.

Treatment:

1.  Rest

2.  Ice

3.  Massage to the bottom of the foot

4.  Stretching– refer to the previous blog topic on Why does my calf cramp?  How do I relieve it?

5.  Night splinting

If the pain is still present, physical therapy can help with Plantar Faciitis.  Consult with your physician or physical therapist to determine the next step for you.    If you have any questions about Plantar Fasciitis, please contact Harbor Physical Therapy.